Title: The videolaryngoscope Airwayscope
bronchial aScope videoscopy easier.

makes theBruno SAUMANDE, M.D.1, Johannes WOLTER, M.D.1, Paul SEGURA, M.D.1, Thierry
POTTECHER, Ph.D., M.D.1 and Pierre DIEMUNSCH, Ph.D., M.D.1. 1Anesthesia and CriticalCare, Hopital de Hautepierre, Strasbourg, France.
Background
The aScope (aS, Ambu, Le Haillan-France) is a new hand held, single patient use
videoscope, for visual guidance during intubation without fiberoptic bundle technology(LED bulb, distal micro camera).It solves some of the core problems of traditional
fibrescopy as: sterilization, availability, maintenance, fragility. The Pentax Airwayscope(AWS, Ambu, Le Haillan-France) is a video laryngoscope with an inbuilt screen and asingle use blade with an integrated channel to guide an endotracheal intubation without astylet. It allows indirect visualization of the glottis. The association of a videollaryngoscope was shown to facilitate the fibrescopic intubation in humans [1].
This study, evaluates the association of the aS with the AWS in the preclinical szetting.
Methods
After informed consent, anesthesiologists who had previously performed < 20fibreoscopies and < 5 AWS intubations were enrolled in this study on a difficult airway
management mannequin (Intubation trainer, KarlStorz, Germany). After theoreticaltraining they attempted, in a randomized sequence, an endoscopic intubation (EI) witheither the aS alone or the aS under AWS control (aS/AWS group).
The primary endpoint was the total time of the EI (t-tot). Secondary endpoints were : themouth-glottis time (t-MG, from the passage of the lips to vocal cords visualization), themouth-carina time (t-MC), a validated check list score (0 to 4 ) [2] and a five-point global
rating scale score [2]. Each EI procedure not completed in 4 min was stopped and wasconsidered as a failure. Anesthesiologist's satisfaction was noted on a digital scale (0 to10). Statistical analysis was performed with Wilcoxon test.
Results
20 EI were performed by 10 anesthesiologists (4 residents and 6 senior physicians). All
the EI assisted by AWS (n=10) were successfully completed at the first attempt. Whenperformed with the aS alone (n=10), 5 EI required more than one attempt : 4 were thencompleted in the allotted 4 min and one case ran out of time. The median t-tot was 140sec [70-265] in the aS alone group and 69 sec [48-81] in the aS/AWS group (p<0.007).
Secondary endpoints are presented in the table. Anesthesiologist's satisfaction was 6.2 [59] with the aS alone and 8.5 [8-9] with the aS/AWS association (p<0.002).

Results
t-MG (sec)t-MC (sec)checklist (0-4)
aS
aS/AWSaS
aS/AWSaS
aS/AWS
37
6110
15
1.9
3.3
5-89
1-13
43-21410-30
0-4
2-4
p<0.007p<0.005p<0.026
all values as median, minimum and maximum

global rating scale score
aS
aS/AWS
3
4.5
1-5
4-5
p<0.011[1] N. Greib. A combined rigid videolaryngoscopy-flexible fibrescopy intubation technique under generalanesthesia. Can J Anesth 2007 ;54 :492-3.
[2] S. Boet. Learning fibreoptic intubation with a virtual computer program transfers to 'hands on'improvement. European Journal of Anaesthesiology 2010, 27:31 35
Funding: There are no funding sources for this abstract.
Summary: In this preclinical series, AWS makes aS use easier according to the defined criteria, allowing
a fast and effective catch in hand by beginners in EI. These results need to be confirmed in the clinicalsetting.
Annual Meeting of the American Society of Airway Management 2010.